Department of Molecular Pathology, Tokyo Medical University, Japan.
Pathol Res Pract. 2013 Jul;209(7):441-7. doi: 10.1016/j.prp.2013.04.012. Epub 2013 May 3.
Although the presence of renal cysts has been reported to be associated with aortic aneurysm or dissection by imaging studies, an autopsy study has not been performed. Therefore, in our institute, recent consecutive adult autopsy cases (n=108, 64 males and 44 females) were reviewed. The circumferences and atherosclerosis ratios of both thoracic and abdominal aorta were individually measured and graded. The number of renal cysts was scored and graded. Age of subjects along with histories of smoking, hypertension, and diabetes mellitus were confirmed. Multiple linear regression analyses demonstrated that severity of atherosclerosis and the number of renal cysts were correlated with thoracic aortic circumference, while only the number of renal cysts was correlated with abdominal aortic circumference (p<0.05), which was more predominant in female subjects (p<0.05). Microscopically, significantly more dilated renal tubules (by Student's t-test, p<0.05) along with decreased stainability of basement membrane by Periodic acid-Schiff staining and immunostaining of type IV collagen were noted in background renal tissues in cases with numerous renal cysts than in age- and sex-matched controls without renal cysts (n=10 vs. 10). The present study suggests that a syndrome that affects both aorta and renal tubules may exist.
虽然影像学研究已经报道了肾囊肿的存在与主动脉瘤或夹层有关，但尚未进行尸检研究。因此，在我们的研究所中，对最近连续的成年尸检病例（n=108，64 名男性和 44 名女性）进行了回顾。单独测量和分级胸主动脉和腹主动脉的周长和动脉粥样硬化比例。对肾囊肿的数量进行评分和分级。确认了受试者的年龄以及吸烟、高血压和糖尿病的病史。多元线性回归分析表明，动脉粥样硬化的严重程度和肾囊肿的数量与胸主动脉周长相关，而只有肾囊肿的数量与腹主动脉周长相关（p<0.05），这在女性受试者中更为明显（p<0.05）。显微镜下，与年龄和性别匹配的无肾囊肿对照组（n=10 对 10）相比，在有大量肾囊肿的病例中，背景肾组织中明显有更多扩张的肾小管（通过学生 t 检验，p<0.05），基底膜的染色性通过过碘酸雪夫染色和 IV 型胶原免疫染色降低。本研究表明，可能存在一种同时影响主动脉和肾小管的综合征。
